Building Up to Major Changes for Private Option

State officials laid out their plans for implementing three new components to Arkansas's Private Option during a meeting of a legislative oversight committee Tuesday. Key changes to the government-purchased private health plan for low-income residents include extending co-pays to some of the poorest private option recipients.

Arkansas Surgeon General Joe Thompson said changes set to begin in February 2015 bring the state into relatively uncharted territory, requiring federal approval.

“Putting cost-sharing on individuals that make only $5,700 a year total is a significant stretch for the federal Center for Medicare, Medicaid Services,” said Thompson.

Those making 50%- 99%of the federal poverty line would be grouped with those making 100-137% FPL in being required to pay co-pays based on a percentage of their income, below 2 percent. The monthly costs range from $5 to $25.

For some of the poorest private option recipients failure to pay co-pays and contribute to a Health Independence Account will mean accruing a debt with the state, but not a denial in service. Thompson said the legislature has the power to decide in the future if they wish to pursue collections or punitive measures against individuals for any debt but advised against it.

Advocates of the changes, which also include limits to non-emergency transportation and enrollment in a program resembling Health Savings Accounts, argue cost-sharing leads to better, consumer-driven health care decisions as they become more familiarized with principles and terms of insurance.

Thompson characterized the cost of implementation as marginal but said it’s an open question if the benefit changes will lead to a better utilization of health care services. He characterized the timeline set to launch programs and get federal waivers by February 1st as "aggressive."